It wasn’t all that long ago that Dr Sue Page was named one of the top ten doctors in Australia to influence general practice. It’s not surprising given her career as a GP has been long and stellar, with a strong rural focus.
“For me, general practice was an easy choice. I really liked the idea of being embedded in the community and exploring the human relationship between people and their clinician. It’s showing the art of medicine not just the science of it.”
Sue’s first patients – her teddy bears
Sue’s interest in medicine started early. She fondly recalls re-enacting tales from her favourite comic book with her brother. The comic featured child characters Dr David, Nurse Susan and their patients, the teddy bears. Through their adventures, they would teach their readers rudimentary first aid.
“One of the teddies would fall down and they would say ‘Oh I have a clean hanky in my pocket and it’s been freshly ironed so it won’t have germs on it. We can use that to tie up the poor teddy’s knee.’ Of course, my brother was David and I was Susan and we played this game quite often. And then he grew up to be a computer programmer and I grew up to be a doctor,” Sue says.
Sue’s parents were instrumental in encouraging her interest in all things cerebral too. She says the best gift she received was a set of Encyclopaedia Britannia on her 14th birthday which she pored through every night.
Another key influence was her primary school principal, Terry Blythe, who she describes as ‘stunning’. She still regards him as being the best teacher she’s had in her entire career.
“He believed children needed to be taught to their level so he’d pull out groups of kids from the classroom and give them one-to-one education. He even taught us to speed-read. He told us we were responsible for our brains and to ensure we were always taking every opportunity to learn.”
Finding her way to medicine
After getting into medicine at Newcastle University, Sue opted to defer her studies. She then took a job as a trainee nurse at Stockton Hospital for a year helping children with profound disabilities.
“It was quite confronting. It was a level of disability that you wouldn’t see these days. They had kids with hydrocephalus who weren’t shunted,” she says. “It really struck me that people’s fundamental sense of humour and how they engage with others can be preserved even when their bodies were disabled.”
She also worked in aged care with dementia sufferers. All of these experiences had an enormous impact on her desire to become a doctor and how she would eventually treat her patients.
“I learned you had to give patient focused care because each individual is so different from the next. I had a much greater understanding of the different pressures on nursing staff too. While they’re expected to physically care for somebody, they can be excluded from decision-making and be powerless over that care,” she says. “This helped me realise I wanted to return to doing medicine but to be the sort of doctor who made my decisions jointly with patients, caregivers and the wider clinical team.”
Deciding on general practice
The move into general practice was a natural step for Sue. She craved the chance to make community connections and explore human relationships, not ‘just the diagnostics’.
“I very rapidly found that I loved all aspects of medicine and couldn’t imagine confining myself to one specialty. Every term just wowed me,” she says. “I also really enjoyed finding out what happened next after seeing someone in the emergency department. Did they get better? Were they okay? With general practice, of course, you get to find the answers to those stories.”
Experiencing rural practice
One of Sue’s first rural experiences was as a medical student during a three-month placement in Central Australia.
“It was awesome. I spent some time in Alice Springs at the Central Australia Aboriginal Commission and then out further at Kalka about 10 hours west of Alice,” she says. “This placement opened my eyes to health inequities and the difficulties people have accessing mainstream services when the doctor may only visit once a fortnight. In other rural areas, the only public transport is the school bus so without a car how do you get to the health service?”
During her career, Sue has practised in many rural and remote communities across Australia from the Northern Territory to South Australia and Queensland. She also worked in the offshore detention centres in Christmas and Manus Islands as well as a maritime doctor, before settling on the north coast of NSW and working with the Indigenous communities in Ballina and Cabbage Tree Island.
Sue believes the key to success in more remote areas is that doctors make a commitment to do more and go beyond nine to five working hours.
“Even for short placements, you need to take on full responsibility. You have to maintain chronic disease databases, issue reminders for vaccinations and do all that admin stuff your practice manager might do in a larger location,’’ she says. “That applies to locums elsewhere too. It doesn’t matter where, you’re not just there to fill a gap. You’re actually that town’s doctor for that period of time and it is important that you do it properly.”
Addressing the rural myths
According to Sue, there are many rural myths that affect registrars and their inclination to practice rural medicine.
“People say, ‘Oh, but you can’t work part time in the country.’ Of course, you can! If you go out to any country town and say I’m willing to work three days a week, they’ll be yelling ‘Pick me! Pick me!’” she says. “In a workforce shortage area, you offer the hours that you’re willing to offer and you are in control of it. If you can’t set your own limits and allow yourself to be worked more than is sustainable for you, that’s your problem. That’s not the town’s problem.”
Registrars may also worry that the support in a rural area is not as comprehensive as that offered in the city. But Sue feels differently.
“I think both the GP colleges play profoundly supportive roles in rural Australia. Pretty much no matter where you are, you’ll be able to find an educational event that’s near you or available online. You’ll be able to get someone on the phone. Some of these things weren’t available 20 or 30 years ago like the GPs Down Under Facebook group. We have an amazing network now from the colleges to the training organisations and workforce agencies to the practice level.”
As for missing out on social activities in a rural community, Sue readily admits there are fewer venue options after hours.
“We don’t have as many of those ‘open all night’ activities. But if you think about your average life as a doctor, you actually don’t go out to a night club every night and you can’t drink when you are on call. There is a difference between your work life and your holiday life. During your holidays, you can still go where you like.”
She says, for the most part, what you do in the country looks exactly the way it does when you’re in the city.
“If we want to go out on the town, maybe that means we drive half an hour to get to the regional centre or fly to a city for the weekend,” she says. “But to balance that, your working life looks awesome. It’s diverse and personal. You’ll look after somebody that you actually recognise because they’re the people that run the store or the garage. Everybody has a role in a rural community and we all give and receive as equals.”
Loving rural life
For Sue, nothing comes close to rural life and the unique opportunities it offers.
“Rural is where you live the dream – you deliver your girlfriends’ babies and they go to the same school as your kids. If someone is hurt or scared or sick you know them. You know their whole self, not just who they are but what they mean to the community,” she says. “It makes it easy to do the work because it’s your family and friends that you are caring for. And then after work, you go home and watch the sun set over the paddock, or over the beach. Or you sit under a tree or you watch the stars. And you know that your children will grow up with just the right values because it takes a community to raise a child, and you are part of an awesome one!”
Taking rural medicine further
Aside from her experience in rural and remote Australia, Sue has advised successive governments on numerous topics such as refugee health, mental health and medical workforce and indemnity issues. She campaigned for the uptake of telehealth in community-based practice and also held a number of key rural roles at The Royal Australian College of General Practitioners and as President of the Rural Doctors Association of Australia. Her outstanding work was recognised in 2008 when she was awarded an Order of Australia.
Moving to Queensland
Today, Sue works at Yeppoon at the Capricorn Coast Hospital and Health Service on a full-time basis. She shares her time between the emergency department and the wards which she finds really interesting.
“It’s satisfying seeing somebody who’s acutely unwell and then getting to watch them on the ward as they get better. I like seeing what happens and then handing them back to their usual GP for that continuity of care,” she says.